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Thursday, April 22, 2010

Toe Injuries: Coban Wrap for Compression and Stabilization



Coban Wrap was supposedly invented by a very smart engineer at 3M Company two years before he invented the glue for post-its. Both products have helped me and I am very grateful. Coban does not stick to your skin. The tape also has a latex-free version and can be found at www.3M.com/ The tape is corrigated to bind to itself. It is a stretch tape, so it gives with swelling. With any wrap, it should not be used if someone as poor circulation, but especially if they lack feeling. When you wrap a foot, or toe like in the photo above, you must be able to feel when it is too tight and should be loosened. It is fairly water-proof, so you can shower with it, and the skin dries under it. I have had patients leave on to protect a corn, or other sore, for a month at a time. The photo above shows the tape being used for compression following a broken toe. This will be on totally for 12 weeks to control the swelling and minimize the pain associated with this swelling. There will always be some stabilization of an injured area with Coban which can help speed healing of fractures. "Buddy taping" is when you tape a broken toe to the toe next to it for greater stability. First you wrap the injured toe completely, then continue the tape over the next toe. The big toe can not be buddy taped. The second toe if broken is taped to the third toe. The third toe if broken is taped to the second or fourth, whichever feels the best. The fourth toe if broken is taped to the third toe. The fifth toe if broken is taped to the fourth toe. The normal amount of time of taping is 3 months.

2 comments:

  1. Hi Dr.Blake,
    Can I use coban for sprained ankle? Currently I am using crepe bandage but over time it becomes quite loose, also I have to remove ot before shower.
    If I can use Coban, can I put it on during shower as well?? Do you recommend any specific time period to use this. My injury is about 4 weeks old now and my doc has advised to use the crepe for 4 more weeks along with ankle support while walking.
    Thank you.
    Manas
    Kolkata. India

    ReplyDelete
  2. Dear Dr.Blake,
    A month ago I sprained my left ankle. There is no fracture and the doctor diagnosed an ATFL grade 2 tear and advised me to follow the RICE method along with an ankle brace while walking.
    After 3 weeks I repeated the X-Ray and no fracture was seen. Currently it has been 4 weeks since the accident and I am using crepe bandage or coban along with the ankle brace.
    I still have pain on the ankle (left foot, left side bone) along with occassional swelling upto the toes. If I remove the crepe and apply cold pack the swelling decreases. So I am not sure if the swelling is caused by a tightly taped crepe bandage. My doctor though told me to wear the crepe all the time for another 4 weeks and continue aceclofenac and paracitamol tablets 2 times a day for 6 days.
    Also, right now I am using sandals. Probably I need to find wide sports shoes which I can wear over the crepe and ankle brace.
    Please give me your advise on how to take care of the sprain for coming 1 or 2 months. I am a geologist and mostly work outdoor.
    Thanks
    Manas

    ReplyDelete

Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.